| NPI | 1760696108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-10242) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 6046-125) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-10-03 |